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INJURIES AND
DEPRESION
Introduction
Spinal cord injury (SCI) is caused by trauma or damage to the spinal cord, resulting in
either a temporary or permanent alteration in the function of the spinal cord (Lewis, Dirksen,
Heitkemper, Bucher, 2014). In the United States alone, it is estimated that there are 276,000
people living with a SCI and there are approximately 12,500 new SCI cases each year. The
average age of injury is 42 years old and males account for 80% of new SCI cases. The most
common causes of SCI in the United States are automotive accidents, falls, acts of violence, and
sports and recreational activities. The most common causes of reduced life expectancy among
SCI patients are pneumonia and septicemia (National Spinal Cord Injury Statistical Center
(NSCISC), 2015). Over the years, there have been improvements in treatment and therapy for
patients with a SCI. Therefore, patients who suffer from a SCI can expect to live a long life after
initial injury (Lewis, Dirksen, Heitkemper, Bucher, 2014).
Correlation between Spinal Cord Injury and Depression
Although the life expectancy for patients with SCIs has been increasing, these patients
still face the risk of suffering from disruptions in individual and developmental growth, body
image issues, alterations in family dynamics, relationship losses, economic hardships, and health
complications secondary to the SCI (Lewis, Dirksen, Heitkemper, Bucher, 2014). Many
individuals who suffer from a SCI adapt to living independently overtime, although some more
serious cases may require personal care attendants for some activities while others may require
around the clock care (Lewis, Dirksen, Heitkemper, Bucher, 2014). These hardships, transition
periods, life changes and health complications may be very difficult for someone with a SCI to
deal with and can lead to changes in mental health status. It is estimated that 1 in 5 individuals
with a SCI suffer from depression (University of Washington, 2016).
immediate time after patients with a SCI were discharged from the hospital (2014). This was
thought to be due to the fact that many patients who suffer from a SCI often spend much of the
initial years after the injury in physical therapy, occupational therapy, and other supportive
environments that allow them to be surrounded by sympathetic and supportive staff. It is not
until later when they gain stability and independence that their social support and interactions
become a more integral part of their lives (Shonenberg et al., 2014).
Researchers found that there are also certain factors in regards to demographics, injury
and discharge that increase an individuals risk for developing MDD after a SCI. For those
individuals at 1 year post SCI, the most at risk population are those who are between the ages of
35-55, unemployed, have an indwelling catheter and have significant deficit in neurologic
function. At five years post injury, those most at risk for MDD are those individuals who are
females, between the ages of 35-55, with a high school education or less, have an indwelling
catheter and have a significant deficit in neurologic function (Arango-Lasprilla, Ketchum,
Starkweather, Nicholls, & Wilk, 2011).
Treatment and Recommendations
The World Health Organization (WHO), explains that many of the medical and mental
health complications associated with SCIs do not result from the injury itself but are secondary
to barriers such as limitations in physical and social environments, inadequate medical care an
rehabilitation services. It is recommended that in order to avoid these consequences, individuals
facing a SCI should receive timely care, access to ongoing healthcare services, education and
products, access to appropriate rehabilitation and access to appropriate assistive devices that
maximize their abilities and independence (WHO, 2016). Medical treatment options for
References
Arango-Lasprilla, J. C., Ketchum, J. M., Starkweather, A., Nicholls, E., & Wilk, A. R. (2011).
Factors predicting depression among persons with spinal cord injury 1 to 5 years post
injury. Neurorehabilitation, 29(1), 9-21
Rogers, V. (2012). Affective Disorders. In J.S. Jone, J. J. Fitzpatrick, & V. L. Rogers. (Eds.),
Psychiatric mental health nursing: An interpersonal approach (pp. 217 241). New
York, NY: Springer.
Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L. (2014). Medical surgical nursing:
Assessment and management of clinical problems. St. Louis, MO: Elsevier.
Mayo Clinic. (2016). Depression (major depressive disorder). Retrieved from
http://www.mayoclinic.org/diseases-conditions/depression/basics/definition/con20032977
National Spinal Cord Injury Statistical Center. (2015). Spinal cord injury (SCI) facts and figures
at a glance. Retrieved from https://www.nscisc.uab.edu/Public/Facts%202015.pdf
Schnenberg, M., Reimitz, M., Jusyte, A., Maier, D., Badke, A., & Hautzinger, M. (2014).
Depression, Posttraumatic Stress, and Risk Factors Following Spinal Cord Injury.
International Journal Of Behavioral Medicine, 21(1), 169-176
University of Washington. (2016). SCI pamphlets: Staying healthy after a spinal cord injury.
Retrieved from http://sci.washington.edu/info/pamphlets/depression_sci.asp
World Health Organization. (2016). Spinal cord injury. Retrieved from
http://www.who.int/mediacentre/factsheets/fs384/en/